Wiki multiple polypectomies

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stogsmom3

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I've recently been receiving denials for multiple polypectomies. I've had the second cpt denied. For example 45385 and 45380-59. The reason doesn't seem to be the problem. I've had screening from positive non-invasive CRC screenings, diagnostic and screenings. This seems to be multiple insurances. Any advise would be greatly appreciated.
 
Hi Melissa,

What my experience is and I've noticed is that several payers will automatically deny multiple polypectomies with a modifier 59. You will have to submit a reconsideration with a copy of the op note to support the modifier. After I do this the payers then come back and pay on those. The payers I've had this issue with are BCBS, Humana, Cigna, and Aetna.
 
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